posted on Jul, 24 2014 @ 07:52 AM
Thanks wrabbit for your breakdown. I am surprised the unsub. rates are not even higher, as when applying for health insurance under the ACA it lets
the purchaser know what their portion and the gov't paid portion would be for each plan, at least here in NJ it does. And the gov't subsidy alone
for our low to middling income is larger than it used to cost us to just straight up buy a good plan with a reasonable deductible.
We've noticed lots of strange unexpected angles with the ACA (Obamacare) insurance, we should have been keeping a list, but here are some things off
the top of my head:
First, as a married couple, ya gotta, by the law apply together unless one of ya can be covered by an employer. If you enter each income separately as
if there is no spouse, it offers excellent coverage, low or no deductible, huge subsidy, low cost to you. Apply together, and your rate goes up, sub.
goes down, deductible shoots wayyyy up, on all plans bronze through gold, there is a totally disproportionate difference as soon as you have 2 persons
instead of one even with very similar lowish incomes. It is such a huge diff in benefits, we have been surprised to not see folks talking about it,
and people predicting a spate of divorces and unmarried couples b/c of it. And, once you're on an ACA plan together, you have to file taxes together,
even if you prefer to file separately.
The deductibles seem designed to make a lot of folks never go to the doc, while the large gov. sub. guarantees a nice chunk of change for the
carrier.
Most crazy thing of all is we got on the ACA plan in June and instead of having an anniversary date for the deductible to begin again, turns out it
turns over in Jan, by law or by the way the fed/state exchanges work(not sure), so gotta pay the whole deductible in 6 months!!! No where does it
disclose this radical departure from custom anywhere when you are buying it - folks at the insurance company themselves where taken aback by this and
had to reconfirm it. Not even in any superfine print or anything that the policy period ends Jan, even if you had to infer it yourself about paying
down the whole deductible in less than a year before getting covered beyond some things falling under wellness care.
Need a colonoscopy? It's covered wellness care so long as they don't find/snip a polyp, but if they so much as take a culture or snip a polyp, the
entire procedure is now treatment - gotta pay up til you reach that deductible and of course still pay a percent after that.
Turns out the plan we chose, under BC/BS, doesn't guarantee that we pay their rates for procedures when we gotta pay out of pocket, docs and
hospitals can set those ridiculous high rates if they choose. This was in the contract's fine details of course, the contract we received after we
paid of course, but who really has time to read so much damn fine print?? Or can understand it all?
Not knowing how the ACA 'Obamacare' would pan out, and hubby w/knee problems, we kept the old insurance on just in case, but now receive a letter
how the cost will go up to about two-and-a-half times what it was to comply with the ACA, while the insurance doesn't actually change much as far as
we can tell.
This is just some of it all... and just the time and stress involved in figuring all this stuff out. I feel so sorry for folks with serious health
problems trying to find their way through this whole mess. Glad for them if they get covered for what they need, but there's got to be a better way.
And seriously, everytime the gov't starts throwing around words, as in 'affordable,' I almost expect another sick joke.